Folic acid deficiency

Question 1

Causes

Answer 1

1). The main cause is poor intake associated with;

• old age
• poverty
• malnutrition, usually associated with alcoholism.

2) . It may be seen in malabsorption
3) . Regular medication with anti-epileptic drugs such as phenytoin.
4) . It is rarely, but very importantly, pregnancy

Question 2

Investigations

Answer 2

The best test is red cell folate (N 360–1400 nmol/L).

Question 3

Replacement therapy

Answer 3

Oral folate 5 mg/d

• to replenish body stores (5–10 mg) in ~4 wks
• continue for 4 months.

Vitamin B12 usually given unless levels normal